Knowledge Translation And Exchange Research Articles

EXACKTE2: Exploiting the clinical consultation as a knowledge transfer and exchange environment: a study protocol

BackgroundWhile the evidence suggests that the way physicians provide information to patients is crucial in helping patients decide upon a course of action, the field of knowledge translation and exchange (KTE) is silent about how the physician and the patient influence each other during clinical interactions and decision-making. Consequently, based on a novel relationship-centered model, EXACKTE2 (EXploiting the clinicAl Consultation as a Knowledge Transfer and Exchange Environment), this study proposes to assess how patients and physicians influence each other in consultations.MethodsWe will employ a cross-sectional study design involving 300 pairs of patients and family physicians from two primary care practice-based research networks. The consultation between patient and physician will be audio-taped and transcribed. Following the consultation, patients and physicians will complete a set of questionnaires based on the EXACKTE2 model. All questionnaires will be similar for patients and physicians. These questionnaires will assess the key concepts of our proposed model based on the essential elements of shared decision-making (SDM): definition and explanation of problem; presentation of options; discussion of pros and cons; clarification of patient values and preferences; discussion of patient ability and self-efficacy; presentation of doctor knowledge and recommendation; and checking and clarifying understanding. Patients will be contacted by phone two weeks later and asked to complete questionnaires on decisional regret and quality of life. The analysis will be conducted to compare the key concepts in the EXACKTE2 model between patients and physicians. It will also allow the assessment of how patients and physicians influence each other in consultations.DiscussionOur proposed model, EXACKTE2, is aimed at advancing the science of KTE based on a relationship process when decision-making has to take place. It fosters a new KTE paradigm by putting forward a relationship-centered perspective and has the potential to reveal unknown mechanisms that underline effective KTE in clinical contexts. This will result in better understanding of the mechanisms that may promote a new generation of knowledge transfer strategies.

Evaluation of a knowledge translation initiative for physical therapists treating patients with work disability

Purpose. We evaluated a knowledge translation and exchange (KTE) initiative aimed at providing physical therapists with best practice information regarding work disability prevention.Method. The KTE initiative involved dissemination of a best practice resource guide for work disability prevention, creation of a network of peer-selected educationally influential clinicians, province-wide seminars for practicing clinicians, and use of the resources in an academic training curriculum. Evaluation included email surveys of clinician practice patterns and exposure to the KTE initiative. We also evaluated the impact of the KTE on community physical therapy workers' compensation outcomes.Results. 241 and 164 clinicians responded to the baseline and follow-up email surveys, respectively. Clinicians reported a wide range of years in practice (0–30+ years) and practice settings although the majority worked in private clinics (∼61%). Approximately 80% of the follow-up sample reported some exposure to the KTE initiative. Few differences were observed in reported practice patterns between survey periods. Compensation outcomes improved slightly after KTE (68 versus 70% off benefits) however, this effect was confounded by proportion of claimants with sprain/strain injury.Conclusions. Implementation of a KTE initiative appears to have had little impact on the clinical practice or outcomes. Future interventions for rehabilitation professionals should consider the organisational culture of the settings in which they practice, which may be a barrier or facilitator of research uptake.

Knowledge to Action: The Development of Training Strategies

This paper presents an overview of curriculum and program development activities at the four Canadian Regional Training Centres directed towards the goal of achieving increased knowledge to action. The RTCs have initiated learning opportunities to increase the skills of graduate students in conducting knowledge translation and exchange (KTE). The authors describe similar as well as unique approaches used at each centre to hone understanding and skills. RTC activities include the development of a new four-year residency program for doctoral students, new Web-based and real-time interactive theory courses and new linkages with departments of journalism. While formal evaluation is yet to be completed, interim feedback from participating graduate students has been encouraging.